Acute Crit Care.  2022 Nov;37(4):601-609. 10.4266/acc.2022.00542.

Association between C-reactive protein-to-albumin ratio and 6-month mortality in out-of-hospital cardiac arrest

• Kim HH
• Lee JH
• Lee DH
• Lee BK

• KMID: 2540148
• DOI: http://doi.org/10.4266/acc.2022.00542

Abstract

Background
The inflammatory response that occurs following cardiac arrest can determine the long-term prognosis of patients who survive out-of-hospital cardiac arrest. We evaluated the correlation between C-reactive protein-to-albumin ratio (CAR) following cardiac arrest and long-term mortality. Methods: The current retrospective observational study examined patients with post-cardiac arrest syndrome (PCAS) treated with targeted temperature management at a single tertiary care hospital. We measured CAR at four time points (at admission and then 24 hours, 48 hours, and 72 hours after) following cardiac arrest. The primary outcome was the patients’ 6-month mortality. We performed multivariable and area under the receiver operating characteristic curve (AUC) analyses to investigate the relationship between CAR and 6-month mortality. Results: Among the 115 patients, 52 (44.1%) died within 6 months. In the multivariable analysis, CAR at 48 hours (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.027–1.244) and 72 hours (OR, 1.241; 95% CI, 1.059–1.455) after cardiac arrest was independently associated with 6-month mortality. The AUCs of CAR at admission and 24, 48, and 72 hours after cardiac arrest for predicting 6-month mortality were 0.583 (95% CI, 0.489–0.673), 0.622 (95% CI, 0.528–0.710), 0.706 (95% CI, 0.615–0.786), and 0.762 (95% CI, 0.675–0.835), respectively. Conclusions: CAR at 72 hours after cardiac arrest was an independent predictor for long-term mortality in patients with PCAS.

Keyword

albumin; C-reactive protein; cardiac arrest; mortality; prognosis

Figure

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  Figure 1. Schematic diagram showing the number of patients in the present study. OHCA: out-of-hospital cardiac arrest; TTM: target temperature management; CRRT: continuous renal replacement therapy; ECMO: extracorporeal membrane oxygenation.

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  Figure 2. Repeated-measures analysis of variance of C-reactive protein (CRP), albumin, and C-reactive protein-to-albumin ratio (CAR) for 6-month mortality and in-hospital mortality 72 hours after cardiac arrest. (A) CRP level and 6-month mortality, (B) CRP level and in-hospital mortality, (C) albumin level and 6-month mortality, (D) albumin level and in-hospital mortality, (E) CAR and 6-month mortality, and (F) CAR and in-hospital mortality. a)P<0.013.

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